AB0366 Pleiotropic Effects of Statins in the Treatment of Inflammatory Joint Diseases

Abstract

Background A lot of clinical studies have shown the beneficial pleiotropic effects of statins: both associated with reduction of cardiovascular risk, and response to the locomotory system such as their effects on: apoptosis, inhibition of NF Kb, the inhibition of TNF alfa and IL6, beneficial effects on angiogenesis, NO/nitrous oxide/, BMP -2 synthesis, increasing bone mineral density, increasing the antioxidant enzymes, etc. Objectives Is there a correlation of the level of CRP, the intake of statin and the effect over the activity of the inflammatory joint diseases such as RA,AS,PsA. Methods We have observed 86 patients with RA, 23 with AS and 13 with psoriatic arthritis treated with Simvastatin at a standard dose of 20 mg. The basic treatment of these patients has not changed during the observation. Of these, 78 patients have been treated with biological DMARDS-anti TNF alpha - medication for 1 year and the remaining 8 patients have been receiving methotrexate monotherapy 10-12.5 mg. weekly dose. The evaluation of the activity is done respectively by DAS 28 for RA, CASPAR - for PsA and BASDAI the AS of 0,4, 8 and 12 weeks, the level of the CRP mg * l and total cholesterol-mmol * l are measured. Results A significant change with reduction of activity in patients with RA has been reported - in 58 patients DAS 28 - was reduced by an average of 1.2, in 28 patients with more than 1.2 in patients with PsA-CASPAR index is reduced by 1.3, in patients with AS BASDAI it is reduced by 2. There is a reduction in CRP values by 8 (4th week), and by 9mg * l (8th week), by 2 (12th week), the cholesterol level is reduced on average in all patients with 1,34 mmol * l from baseline. Conclusions Our observation has shown the effect of statins, particularly the effect of Sinvastatin on acute phase and the favorable effects of the implementation of their many pleiotropic effects, and in particular - the anti-inflammatory effects. At this stage, statins are not included in the recommendations for the treatment of these diseases, but perhaps in the future they will be, after the completion of numerous clinical studies and presentation of results. References Chiang CE, Pella D, Singh RB. Coenzyme Q10 and adverse effects of statins. J Nutritional and Environmental Med 2004; 14:1-12. Shepherd J. Fibrates and statins in the treatment of hyperlipidaemia: an appraisal of their efficacy and safety. Eur Heart J 1995; 16:5-13. Mason RP, Jacob RF. Membrane microdomains and vascular biology: emerging role in atherogenesis. Circulation 2003; 107:2270-3. McKenney JM, Jones PH, Adamczyk MA. For the STELLARStudy Group. Comparison of efficacy of rosuvastatin versus atorvastatin, simvastatin, and pravastatin in achieving lipid goals: results from the STELLAR trial. Curr Med Res Opin 2003; :557-66. Law MR, Wald NJ, Rudnicka AR. Quantifying effect of statins on low-density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ 2003;326: 1423. Disclosure of Interest None declared DOI ...